We all agree that we would like to see a way to measure quality and to find alternative payment forms, but at what cost? The cost of all of the reporting is becoming so expensive and so time consuming that small primary care practices cannot afford to stay open. Many of these primary care providers are looking for positions that do not involve patient care; some are starting boutique practices; and others are going into corporate medicine.
When was the last time you tried to get a new primary care physician? If you can find one taking patients, you are fortunate if you only have to wait three months. You may have to wait even longer to see a specialist: five to six months. Then, you need to find one that will take your insurance. Many hospitals and corporations try very hard to find enough physicians to adequately serve their populations. They are also faced with a frequent turnover of physicians working for them. It may be that forcing physicians into large group practices may be the better way to go if we really want to measure outcomes. But will patients like it? And if they don’t, will it have a negative effect on the individual’s health?
As leaders in health care quality improvement, we have many questions: Will we need to add many more parameters to measure quality? Will quality measures include the patient's point of view? When a patient becomes ill, how long will he need to wait to see his personal physician? Will he need to see the next provider in the queue? Or should he just go to urgent care or the emergency department? As corporations struggle to try to personalize patient care, more and more obstacles are put in their path. And the cost becomes more expensive.